The Grenfell Tower Inquiry
published its second and final report on 4 September. The report
is 7 volumes and 1,700 pages and sums up the Inquiry's findings as
follows:
"We conclude that the fire at
Grenfell Tower was the culmination of decades of failure by central
government and other bodies in positions of responsibility in the
construction industry to look carefully into the dangers of
incorporating combustible materials into the external walls of
high-rise residential buildings and to act on the information
available to them."
The fire killed 72 people in
2017. The Inquiry's first report found the cladding to have
been the "principal" reason for the blaze's rapid spread. Its
second report looks at the causes of the fire. It
concludes:
- The Government was warned
about cladding fires in 1992 when the 11-storey Knowsley Heights
tower in Merseyside caught fire. In 1999 there was another fire at
Garnock Court in Irvine, North Ayrshire, and a committee of MPs
repeated the concerns. But no action was taken to ban
flammable cladding because it had already been classed as meeting a
British safety standard.
- Safety tests in 2001
revealed the type of cladding in question "burned violently". The
results were kept confidential and the Government did not tighten
any rules. "We do not understand the failure to act on
a matter of such importance," the inquiry panel said.
- In 2009, six people died in
a fire at Lakanal House, a high-rise in South London. The coroner
at their inquests asked for a review of building regulations but,
the inquiry found, this was "not treated with any sense of
urgency."
- In 2010 the coalition
government committed to cut "red tape" it saw as holding back
British business. The inquiry found this policy so "dominated" the
thinking in government that "even matters affecting the safety of
life were ignored, delayed or disregarded."
- The government department
responsible for housing was "poorly run" and fire safety had been
left in the hands of a relatively junior official. Privatisation of
the Building Research Establishment in 1997 exposed it to
"unscrupulous product manufacturers."
- The inquiry found
there had been "systematic dishonesty" from those who
made and sold the cladding. Arconic, a manufacturer, "deliberately
concealed" the true extent of the danger of the cladding used to
wrap Grenfell Tower as a rain-proof barrier. Fire tests it
commissioned showed that the cladding performed poorly. However,
this information was not given to the BBA, a British private
certification company tasked with keeping the construction
industry up to
date. This
"caused BBA to make statements that Arconic knew were 'false and
misleading'", the report says.
- Two firms made the
insulation behind the cladding panels. Celotex made
"false and misleading claims" about its product being suitable.
Kingspan, which made 5% of the insulation, had misled the market by
not revealing the limitations of its product.
- Installation of the cladding
at Grenfell was poorly managed by contractors and the Royal Borough
of Kensington and TMO.
- During installation, there
was a failure to establish who was responsible for safety standards
- resulting in an "unedifying 'merry-go-round of buck-passing'".
Studio E, the architect, Rydon, the principal contractor, and
Harley Facades, the cladding sub-contractor, "all took a casual
approach to contractual relations. They did not properly understand
the nature and scope of the obligations they had undertaken, or, if
they did, paid scant attention to them."
- Studio E, the architect,
"bears a very significant degree of responsibility for the
disaster" because it had failed to recognise the cladding was
combustible.
- Harley Facades "bears
significant responsibility" because it had not concerned itself
with fire safety at any stage."
- Rydon failed to make clear
which contractor was responsible for what - and it failed "to take
an active interest in fire safety."
- There was a breakdown in
trust and relations between the TMO and residents, which led to a
"serious failure to observe responsibilities". The TMO showed
a "persistent indifference" to fire safety and the needs of
vulnerable residents.
- The London Fire Brigade had
known since the 2009 Lakanal fire that it faced challenges in
fighting blazes in high-rise blocks. The firefighters who went into
Grenfell had not been prepared for what they would face. Senior
officers had been complacent and lacked the skills to recognise the
problems and correct them. There was a failure to share knowledge
about cladding fires, a failure to plan for a large number of 999
calls, or train staff on what to tell trapped
residents.
The report concludes with 18
pages of recommendations, covering all aspects of its
findings. In response to the shortcomings of the TMO, it
judges the enactment of the Social Housing (Regulation) Act and the
implementation of the new regulatory regime to be a sufficient
response and does not make any further recommendations.